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NPI Code Detail

MEDICARE: KILEY MORGAN PERETHIAN D.O.

MEDICARE: KILEY MORGAN PERETHIAN D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician4714TN

General Provider Information

NPI Number : 1851852321
Entity Type Code : Individual
Provider Name (Legal Business Name) : KILEY MORGAN PERETHIAN D.O.
Provider Business Mailing Address
First Line : 1021 W OAKLAND AVE STE 310
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-2192
Country : US
Telephone Number : 423-952-2111
Fax Number :
Provider Business Practice Location Address
First Line : 111 W STONE DR STE 200
Second Line :
City : KINGSPORT
State : TN
Zip : 37660-6028
Country : US
Telephone Number : 423-723-2030
Fax Number : 423-247-4110
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2019
Last Update Date : 01/05/2026

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Directions to “ KILEY MORGAN PERETHIAN D.O.” Practice Location

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